References of "REGINSTER, Jean-Yves"
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See detailExploring the Interest in and the Usage of the Internet Among Patients Eligible for Osteoporosis Screening.
Slomian, Justine ULg; Reginster, Jean-Yves ULg; Gaspard, Ulysse ULg et al

in Calcified tissue international (in press)

The aim of this study was to evaluate the interest in the Internet and its usage for health-related issues among people eligible for osteoporosis screening. Self-administered questionnaires have been ... [more ▼]

The aim of this study was to evaluate the interest in the Internet and its usage for health-related issues among people eligible for osteoporosis screening. Self-administered questionnaires have been distributed to subjects who were screened for osteoporosis and to menopausal women. 177 patients have responded to the survey (64.5 +/- 10.1 years, 88.1 % of women). There are 78.5 % of Internet users. Among them, 67.2 % said searching information about their health and 74.5 % said using the Internet for this purpose. All respondents attributed an average score, out of 10, of 5.7 +/- 2.3 regarding the reliability of information that they could find on the Internet. The use of the Internet differs significantly depending on age: those who use the Internet are younger (62.1 +/- 8.91 years) than those who do not use it (73.3 +/- 9.42 years). The socioeconomic status also has an impact on the Internet use: Internet users have a higher education, are more professionally active and have a higher net monthly household income compared to the group of non-users. Even if age and socioeconomic status appear to be determining factors in the use of the Internet for the search of health information in patients eligible for osteoporosis screening, almost 75 % of the study population use the Internet for this purpose. Action to promote health through an Internet platform must therefore take these parameters into account. [less ▲]

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See detailDiabetes is a risk factor for knee osteoarthritis progression
Eymard, F; Parsons, C; Edwards, M et al

in Osteoarthritis and Cartilage (in press)

Purpose Recent studies have suggested that metabolic factors (obesity, diabetes, hypertension and dyslipidemia) and their clustering in metabolic syndrome (MetS) might be involved in the pathophysiology ... [more ▼]

Purpose Recent studies have suggested that metabolic factors (obesity, diabetes, hypertension and dyslipidemia) and their clustering in metabolic syndrome (MetS) might be involved in the pathophysiology of knee osteoarthritis (OA). We investigated their impact on radiographic progression by an annualised measure of the joint space narrowing (JSN) of the medial tibiofemoral compartment. Methods 559 patients older than 50 years with symptomatic knee OA were recruited for the placebo arm of the SEKOIA trial. The presence of diabetes, hypertension and dyslipidemia was determined at baseline interview. BMI was calculated, obesity was considered >30 kg/m2. MetS was defined by the sum of metabolic factors ≥3. Minimal medial tibiofemoral joint space on plain radiographs was measured by an automated method at baseline and then annually for up to 3 years. Results The mean age of patients was 62.8 [62.2-63.4] years; 392 were women. A total of 43.8% was obese, 6.6% had type 2 diabetes, 45.1% hypertension, 27.6% dyslipidemia and 13.6% MetS. Mean annualised JSN was greater for patients with type 2 diabetes than without diabetes (0.26 [-0.35 - -0.17] vs. 0.14 [-0.16 - -0.12] mm; p=0.001). This association remained significant after adjustment for sex, age, BMI, hypertension and dyslipidemia (p=0.018). In subgroup analysis, type 2 diabetes was a significant predictor of JSN in males but not females. The other metabolic factors and MetS were not associated with annualised JSN. Conclusion Type 2 diabetes was a predictor of joint space reduction in men with established knee OA. No relationships were found between MetS or other metabolic factors and radiographic progression. [less ▲]

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See detailCommentary on recent therapeutic guidelines for osteoarthritis
Cutolo, M; Berenbaum, F; Hochberg, M et al

in Seminars in Arthritis & Rheumatism (in press)

Background Despite availability of international evidence-based guidelines for osteoarthritis (OA) management, agreement on the different treatment modalities is lacking. Method A symposium of European ... [more ▼]

Background Despite availability of international evidence-based guidelines for osteoarthritis (OA) management, agreement on the different treatment modalities is lacking. Method A symposium of European and US OA experts was held within the framework of the Annual European Congress of Rheumatology to discuss and compare guidelines and recommendations for the treatment of knee OA and to reach a consensus for management, particularly for areas in which there is no clear consensus: non-pharmacological therapy; efficacy and safety of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs); intra-articular (i.a.) hyaluronates (HA); and the role of chondroitin sulfate (CS) and/or glucosamine sulfate (GS). Results All guidelines reviewed agree that knee OA is a progressive disease of the joint whose management requires non-pharmacological and pharmacological approaches. Discrepancies between guidelines are few and mostly reflect heterogeneity of expert panels involved, geographical differences in the availability of pharmacotherapies, and heterogeneity of studies included. Panels chosen for guideline development should include experts with real clinical experience in drug use and patient management. Implementation of agreed guidelines can be thwarted by drug availability and reimbursement plans, resulting in optimal OA treatment being jeopardized, HA and symptomatic slow-acting drugs for osteoarthritis (SySADOAs) being clear examples of drugs whose availability and prescription can greatly vary geographically. In addition, primary care providers, often responsible for OA management (at least in early disease), may not adhere to clinical care guidelines, particularly for non-pharmacological OA treatment. Conclusion Harmonization of the recommendations for knee OA treatment is challenging but feasible, as shown by the step-by-step therapeutic algorithm developed by European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). More easily disseminated and implemented guidance for OA treatment in the primary care setting is key to improved management of OA. [less ▲]

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See detailDabigatran Etexilate and Risk of Myocardial Infarction, Other Cardiovascular Events, Major Bleeding, and All-Cause Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Douxfils, Jonathan; Buckinx, Fanny ULg; Mullier, Francois et al

in Journal of the American Heart Association (in press)

BACKGROUND: Signals of an increased risk of myocardial infarction (MI) have been identified with dabigatran etexilate in randomized controlled trials (RCTs). METHODS AND RESULES: We conducted searches of ... [more ▼]

BACKGROUND: Signals of an increased risk of myocardial infarction (MI) have been identified with dabigatran etexilate in randomized controlled trials (RCTs). METHODS AND RESULES: We conducted searches of the published literature and a clinical trials registry maintained by the drug manufacturer. Criteria for inclusion in our meta-analysis included all RCTs and the availability of outcome data for MI, other cardiovascular events, major bleeding, and all-cause mortality. Among the 501 unique references identified, 14 RCTs fulfilled the inclusion criteria. Stratification analyses by comparators and doses of dabigatran etexilate were conducted. Peto odds ratio (ORPETO) values using the fixed-effect model (FEM) for MI, other cardiovascular events, major bleeding, and all-cause mortality were 1.34 (95% CI 1.08 to 1.65, P=0.007), 0.93 (95%CI 0.83 to 1.06, P=0.270), 0.88 (95% CI 0.79 to 0.99, P=0.029), and 0.89 (95% CI 0.80 to 1.00, P=0.041). When compared with warfarin, ORPETO values using FEM were 1.41 (95% CI 1.11 to 1.80, P=0.005), 0.94 (95%CI 0.83 to 1.06, P=0.293), 0.85 (95% CI 0.76 to 0.96, P=0.007), and 0.90 (95% CI 0.81 to 1.01, P=0.061), respectively. In RCTs using the 150-mg BID dosage, the ORPETO values using FEM were 1.45 (95% CI 1.11 to 1.91, P=0.007), 0.95 (95% CI 0.82 to 1.09, P=0.423), 0.92 (95% CI 0.81 to 1.05, P=0.228), and 0.88 (95% CI 0.78 to 1.00, P=0.045), respectively. The results of the 110-mg BID dosage were mainly driven by the RE-LY trial. CONCLUSIONS: This meta-analysis provides evidence that dabigatran etexilate is associated with a significantly increased risk of MI. This increased risk should be considered taking into account the overall benefit in terms of major bleeding and all-cause mortality. [less ▲]

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See detailComment optimiser l’efficience de l’aide internationale, dans le domaine de la santé, en République Démocratique du Congo
Manzambi Kuwekita, Joseph ULg; Bruyère, Olivier ULg; Guillaume, Michèle ULg et al

in Santé Publique : Revue Multidisciplinaire pour la Recherche et l'Action (2015), 27(Janvier-Févier), 129-134

Analysis of national health insurance accounts in the Democratic Republic of Congo (DRC) clearly shows the importance of international sanitary aid, particularly for the funding of general referral ... [more ▼]

Analysis of national health insurance accounts in the Democratic Republic of Congo (DRC) clearly shows the importance of international sanitary aid, particularly for the funding of general referral hospitals, the management of inpatients with AIDS, administration of health zones and funding of preventive care providers. It The targeted changes described in this article could possibly optimize the efficiency of international aid for the DRC population, mainly for disorders considered to be a health care priority (i.e. malaria, AIDS, tuberculosis) as well as in the fight against malnutrition. Recommendations target the implementation of procedures for control of food chain security, changes in lifestyle and dietary habits of the population but also comprise extensive restructuring of the health care administration. A dramatic change of the structure in charge of drug distribution as well as eradication of the transfer of part of public health structure income to public health administrative personnel could result in the allocation of significant funds to the fight against the most important diseases. Better collaboration between the various departments in charge of health care professional training, together with enhanced responsibility of health care personnel is essential. Independent and respected non-governmental organizations should be involved in an audit process, targeting all aspects of the current DRC health system. Eventually, in an equal opportunity perspective, taking into consideration the very high degree of poverty of DRC inhabitants, implementation of health insurance programmes, use of generic drugs and generalization of micro-credit initiatives should also be implemented. [less ▲]

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See detailConcordance between muscle mass assessed by bioelectrical impedance analysis and by dual energy X-ray absorptionmetry among elderly people: a cross-sectional study
Buckinx, Fanny ULg; Reginster, Jean-Yves ULg; Dardenne, Nadia ULg et al

in BMC Musculoskeletal Disorders (2015), 16(1), 60-67

BACKGROUND: Besides magnetic resonance imaging, dual energy X-ray absorptiometry (DXA) seems the most reliable tool to evaluate body composition and is often considered as the gold standard in clinical ... [more ▼]

BACKGROUND: Besides magnetic resonance imaging, dual energy X-ray absorptiometry (DXA) seems the most reliable tool to evaluate body composition and is often considered as the gold standard in clinical practice. Bioelectrical impedance analysis (BIA) could provide a simpler, portative, and less expensive alternative. Because the body composition assessment by BIA is device-dependent, the aim of this study was to appraise the concordance between the specific bioelectrical impedance device InBody S10 and DXA for the body composition evaluation. METHODS: Body composition, included appendicular lean mass divided by height squared (ALM/ht2) was measured by DXA (Hologic QDR Discovery device) and by BIA (InBody S10 Biospace device). Agreement between tools was assessed by means of the Bland Altman method and reliability was determined using the IntraClass Coefficient (ICC). ICC was also computed to assess the reliability of the test-retest performed by the same operator or by two different ones. RESULTS: A total of 219 subjects were enrolled in this study (mean age: 43.7 +/- 19.1 years old, 51.6% of women). For the ALM/ht2, reliability of the test-retest of the BIA was high with an ICC of 0.89 (95%CI: 0.86-0.92) when performed by the same operator and an ICC of 0.77 (95%CI: 0.72-0.82) when performed by two different operators. Agreement between ALM/ht2 assessed by DXA and BIA was low (ICC = 0.37 (95%CI: 0.25-0.48)). Mean ALM/ht2 was 9.19 +/- 1.39 kg/m2 with BIA and 7.34 +/- 1.34 kg/m2 with DXA, (p < 0001). A formula developed using a multiple regression analysis, and taking into account muscle mass assessed by BIA, as well as sex and body mass index, explains 89% of the ALM/ht2 assessed by DXA. CONCLUSIONS: Although our results show that the measure of ALM/ht2 by BIA is reliable, the agreement between DXA and BIA is low. Indeed, BIA seems to overestimate ALM/ht2 compared to DXA and, consequently, it is important to use an adapted formula to obtain measurement of the appendicular lean mass by BIA close to that measured by DXA. [less ▲]

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See detailComments on the discordant recommendations for the use of symptomatic slow acting drugs in knee osteoarthritis.
Reginster, Jean-Yves ULg; Cooper, Cyrus; Hochberg, Marc et al

in Current medical research and opinion (2015), 31(5), 1041-1045

Abstract Despite the near concurrent publication by influential scientific organizations, there are important differences in interpretation of the evidence base and the conclusions derived from the recent ... [more ▼]

Abstract Despite the near concurrent publication by influential scientific organizations, there are important differences in interpretation of the evidence base and the conclusions derived from the recent Osteoarthritis Research Society International (OARSI) guidelines for the management of knee osteoarthritis, the American College of Rheumatology (ACR) (concerning also hip and hand osteoarthritis) and the algorithm recommendations by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). This is particularly evident for the drug class of Symptomatic Slow-Acting Drugs in OsteoArthritis. In this paper, we highlight these differences and try to understand where they derive from, proposing an evidence-based interpretation. [less ▲]

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See detailA 24-month Study Evaluating the Efficacy and Safety of Denosumab for the Treatment of Men With Low Bone Mineral Density: Results From the ADAMO Trial.
Langdahl, Bente L.; Teglbjaerg, Christence S.; Ho, Pei-Ran et al

in The Journal of clinical endocrinology and metabolism (2015), 100(4), 1335-1342

Context: One in 4 men in the US aged >50 will suffer an osteoporosis-related fracture. Less data are available on osteoporosis treatment in men than women. Objective: Evaluate denosumab therapy in men ... [more ▼]

Context: One in 4 men in the US aged >50 will suffer an osteoporosis-related fracture. Less data are available on osteoporosis treatment in men than women. Objective: Evaluate denosumab therapy in men with low BMD. Design: Phase 3 study with two treatment periods: a previously reported 12-month double-blind, placebo-controlled phase and a 12-month open-label phase. Setting: Multicenter in North America and Europe. Participants: 228 men entered the open-label phase and 219 completed the study. Intervention: Men from the original denosumab (long-term) and placebo (crossover) groups received denosumab 60 mg SC every 6 months. Main Outcome Measures: BMD, serum C-telopeptide (sCTX), and safety. Results: During the open-label phase, continued BMD increases occurred with long-term denosumab treatment (2.2% lumbar spine; 0.9% total hip; 1.3% femoral neck; 1.3% trochanter; and 0.2% 1/3 radius), resulting in cumulative 24-month gains from baseline of 8.0%, 3.4%, 3.4%, 4.6%, and 0.7%, respectively (all P<0.01). The crossover group showed BMD gains after 12 months of denosumab treatment similar to the long-term denosumab group during the first treatment year. Significant reductions in sCTX were observed following denosumab administration. Adverse events rates were similar between groups and no new safety signals identified. Conclusions: In men with low BMD, denosumab treatment for a second year continued to increase BMD, maintained reductions in bone resorption, and was well tolerated. BMD increased in men initiating denosumab during the second year. These effects were similar to those previously seen in postmenopausal women with osteoporosis and men with prostate cancer on androgen deprivation therapy. [less ▲]

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See detailLetter to the Editor.
Bruyère, Olivier ULg; Reginster, Jean-Yves ULg

in Seminars in arthritis and rheumatism (2015), 44(5), 15

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